Summary of Job Respond to written/verbal grievances, complaints, appeals and disputes submitted by members... and providers in accordance with NCQA, CMS, State and other regulations. Process appeals and grievances to facilitate the accurate...
Summary of Job Respond to written/verbal grievances, complaints, appeals and disputes submitted by members... and providers in accordance with NCQA, CMS, State and other regulations. Process appeals and grievances to facilitate the accurate...
criteria. Enters data and assists with compiling reports and analysis on the grievance and appeals process. Participates..., including a minimum of two years in a grievance and appeals or related area such as medical or utilization management...